総体症状、症候学

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/24 22:59:23」(JST)

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A symptom (from Greek σύμπτωμα, "accident, misfortune, that which befalls",^[1] from συμπίπτω, "I befall", from συν- "together, with" and πίπτω, "I fall") is a departure from normal function or feeling which is noticed by a patient, reflecting the presence of an unusual state, or of a disease. A symptom is subjective,^[2] observed by the patient,^[3] and cannot be measured directly,^[4] whereas a sign is objectively observable by others. For example, paresthesia is a symptom (only the person experiencing it can directly observe their own tingling feeling), whereas erythema is a sign (anyone can confirm that the skin is redder than usual). Symptoms and signs are often nonspecific, but often combinations of them are at least suggestive of certain diagnoses, helping to narrow down what may be wrong. In other cases they are specific even to the point of being pathognomonic.

The term is sometimes also applied to physiological states outside the context of disease, as for example when referring to "symptoms of pregnancy".

Types

Symptoms may be chronic, relapsing or remitting. Asymptomatic conditions also exist (e.g. subclinical infections and, sometimes, high blood pressure).

Constitutional or general symptoms are those related to the systemic effects of a disease (e.g., fever, malaise, anorexia, and weight loss). They affect the entire body rather than a specific organ or location.

The terms "chief complaint", "presenting symptom", "iatrotropic symptom", or "presenting complaint" are used to describe the initial concern which brings a patient to a doctor. The symptom that ultimately leads to a diagnosis is called a "cardinal symptom".

Non-specific symptoms are self-reported symptoms that do not indicate a specific disease process or involve an isolated body system. For example, fatigue is a feature of many acute and chronic medical conditions, which may or may not be mental, and may be either a primary or secondary symptom. Fatigue is also a normal, healthy condition when experienced after exertion or at the end of a day.

Positive and negative

In describing mental disorders,^[5]^[6] especially schizophrenia, symptoms can be divided into positive and negative symptoms.^[7]

Positive symptoms are symptoms present in the disorder but not normally experienced by most individuals. It reflects an excess or distortion of normal functions (i.e., experiences and behaviors that have been added to a person’s normal way of functioning).^[8] Examples are hallucinations, delusions, and bizarre behavior.^[5]
Negative symptoms are functions that are normally found in healthy persons, but that are diminished or not present in affected persons. Thus, it is something that has disappeared from a person’s normal way of functioning.^[8] Examples are social withdrawal, apathy, inability to experience pleasure and defects in attention control.^[6]

Possible causes

Some symptoms occur in a wide range of disease processes, whereas other symptoms are fairly specific for a narrow range of illnesses. For example, a sudden loss of sight in one eye has a significantly smaller number of possible causes than nausea does.

Some symptoms can be misleading to the patient or the medical practitioner caring for them. For example, inflammation of the gallbladder often gives rise to pain in the right shoulder, which may understandably lead the patient to attribute the pain to a non-abdominal cause such as muscle strain.

Symptom versus sign

A symptom can more simply be defined as any feature which is noticed by the patient. A sign is noticed by other people. It is not necessarily the nature of the sign or symptom which defines it, but who observes it.

A feature might be a sign or a symptom - or both - depending on the observer(s). For example, a skin rash may be noticed by either a healthcare professional as a sign, or by the patient as a symptom. When it is noticed by both, then the feature is both a sign and a symptom. In lists of features to expect in the history and physical examination, "rash" may be listed under both (constituting a symptom in the former, a sign in the latter).

Some features, such as pain, can only be symptoms, because they cannot be directly observed by other people. Other features can only be signs, such as a blood cell count measured in a medical laboratory, which most patients have no way to observe independently.

References

^ "Sumptoma, Henry George Liddell, Robert Scott, ''A Greek-English Lexicon'', at Pursues". Perseus.tufts.edu. Retrieved 2011-12-17.
^ Pathology - Glossary^{[dead link]}
^ eMedicine/Stedman Medical Dictionary Lookup!^{[dead link]}
^ Devroede G (1992). "Constipation—a sign of a disease to be treated surgically, or a symptom to be deciphered as nonverbal communication?". J. Clin. Gastroenterol. 15 (3): 189–91. doi:10.1097/00004836-199210000-00003. PMID 1479160.
^ ^a ^b "Encyclopedia of Mental Disorders: positive symptom". Minddisorders.com. Retrieved 2011-12-17.
^ ^a ^b http://www.minddisorders.com/Kau-Nu/Negative-symptoms.html Encyclopedia of Mental Disorders: negative symptom
^ "Mental Health: a Report from the Surgeon General". Surgeongeneral.gov. Retrieved 2011-12-17.
^ ^a ^b Understanding Psychosis, Mental Health Illness of Australia.

UpToDate Contents

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English Journal

Implicit and explicit self-esteem and their reciprocal relationship with symptoms of depression and social anxiety: A longitudinal study in adolescents.

van Tuijl LA, de Jong PJ, Sportel BE, de Hullu E, Nauta MH.Author information Department of Clinical Psychology, University of Groningen, The Netherlands. Electronic address: L.A.van.tuijl@rug.nl.AbstractBACKGROUND AND OBJECTIVES: A negative self-view is a prominent factor in most cognitive vulnerability models of depression and anxiety. Recently, there has been increased attention to differentiate between the implicit (automatic) and the explicit (reflective) processing of self-related evaluations. This longitudinal study aimed to test the association between implicit and explicit self-esteem and symptoms of adolescent depression and social anxiety disorder. Two complementary models were tested: the vulnerability model and the scarring effect model.
Journal of behavior therapy and experimental psychiatry.J Behav Ther Exp Psychiatry.2014 Mar;45(1):113-21. doi: 10.1016/j.jbtep.2013.09.007. Epub 2013 Sep 27.
BACKGROUND AND OBJECTIVES: A negative self-view is a prominent factor in most cognitive vulnerability models of depression and anxiety. Recently, there has been increased attention to differentiate between the implicit (automatic) and the explicit (reflective) processing of self-related evaluations.
PMID 24135033

Validity, reliability and prevalence of four 'clinical content' subtypes of depression.

Sharpley CF1, Bitsika V2.Author information 1Brain-Behaviour Research Group, University of New England, Armidale, NSW 2351, Australia. Electronic address: csharpley@onthenet.com.au.2Brain-Behaviour Research Group, Bond University, Gold Coast, QLD 4229, Australia.AbstractAlthough depression is often diagnosed via reference to a list of nine criteria which may be used to form a unitary diagnosis, there is significant variation in the content of those nine criteria to justify consideration of four 'clinical content' subtypes of depression based upon differences in symptomatology. Each of those four subtypes has previously been described for their different causes, underlying neurobiological pathways, and treatment requirements. This paper reports on the validity, reliability and prevalence of those four subtypes of depression across three samples of participants. Validity is demonstrated and satisfactory reliability values are reported for each subtype, plus significant correlations between items used to measure each subtype, arguing for the individual homogeneity of each of these four subtypes. Prevalence data indicated that there were significant subtype differences at the sample and individual level, challenging the usage of a single global depression score. These results argue for further consideration of these subtypes when researching depression and in planning individualised treatment regimes.
Behavioural brain research.Behav Brain Res.2014 Feb 1;259:9-15. doi: 10.1016/j.bbr.2013.10.032. Epub 2013 Oct 27.
Although depression is often diagnosed via reference to a list of nine criteria which may be used to form a unitary diagnosis, there is significant variation in the content of those nine criteria to justify consideration of four 'clinical content' subtypes of depression based upon differences in sym
PMID 24172219

Genetic Overlap between Evoked Frontocentral Theta-Band Phase Variability, Reaction Time Variability, and Attention-Deficit/Hyperactivity Disorder Symptoms in a Twin Study.

McLoughlin G1, Palmer JA2, Rijsdijk F3, Makeig S2.Author information 1Swartz Center for Computational Neuroscience, Institute for Neural Computation, La Jolla, California; Department of Psychiatry, University of California San Diego, La Jolla, California. Electronic address: gmcloughlin@ucsd.edu.2Swartz Center for Computational Neuroscience, Institute for Neural Computation, La Jolla, California.3Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, United Kingdom.AbstractBACKGROUND: Electrophysiological and hemodynamic activity is altered in attention-deficit/hyperactivity disorder (ADHD) during tasks requiring cognitive control. Frontal midline theta oscillations are a cortical correlate of cognitive control influencing behavioral outcomes including reaction times. Reaction time variability (RTV) is consistently increased in ADHD and is known to share genetic effects with the disorder. The etiological relationship between the cognitive control system, RTV, and ADHD is unknown. In a sample of twins selected for ADHD and matched control subjects, we aimed to quantify the strength of the phenotypic, genetic, and environmental relationships between event-related midline theta oscillations, RTV, and ADHD.
Biological psychiatry.Biol Psychiatry.2014 Feb 1;75(3):238-47. doi: 10.1016/j.biopsych.2013.07.020. Epub 2013 Aug 31.
BACKGROUND: Electrophysiological and hemodynamic activity is altered in attention-deficit/hyperactivity disorder (ADHD) during tasks requiring cognitive control. Frontal midline theta oscillations are a cortical correlate of cognitive control influencing behavioral outcomes including reaction times.
PMID 24001472

Japanese Journal

検査デバイスや症候学的スキルを駆使した地域住民へのヘルスアセスメント

赤川信一郎,森川則文,池田佳代 [他],岡崎照夫,高橋俊輔
薬学雑誌. 乙号 135(2), 175-179, 2015
A strategy named "Japan is back" adopted in June 2013 specifies that pharmacies shall be regarded as community-based places where health-related information is provided, and the public shall be enco …
NAID 130004756493